We identified a 20% sample of all Medicare beneficiaries who died between the ages of 66 and 99 years during the period 2003-07. Data for 2010-12 are based on a 100% sample of claims. We excluded beneficiaries without continuous Part A and Part B coverage in the last six months of life or who were enrolled in Medicare health maintenance organizations (i.e., Medicare Advantage). From these decedents, we identified those with poor prognosis cancer diagnoses on at least one hospital claim or at least two clinician visits in the last six months of life. We then categorized decedents into one of 26 cancer types based on their predominant cancer diagnosis using a modified Clinical Classification Software (CCS) approach; please see the Methods of our cancer report for details.

ADJUSTMENTS:

Although all of these patients died of serious cancer, groups of patients across hospitals or regions may have differed by other characteristics such as the composition of age, sex or race. All rates are adjusted with the following patient level characteristics: age, race (black/non-black), sex, cancer type, and non-cancer chronic conditions.

The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health
Policy and Clinical Practice and is supported by a coalition of funders led by the Robert Wood Johnson Foundation,
including the WellPoint Foundation, the United Health Foundation, the California HealthCare Foundation, and the Charles H. Hood Foundation.